Healthcare Provider Details

I. General information

NPI: 1891925772
Provider Name (Legal Business Name): MINNEAPOLIS SENIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2009
Last Update Date: 07/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 3RD ST N
WAITE PARK MN
56387-1121
US

IV. Provider business mailing address

510 3RD ST N
WAITE PARK MN
56387-1121
US

V. Phone/Fax

Practice location:
  • Phone: 320-258-3088
  • Fax:
Mailing address:
  • Phone: 320-258-3088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL ARNOLD
Title or Position: OWNER
Credential:
Phone: 320-258-3055